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Merkel cell carcinoma: demographic, clinical, and treatment parameters of prognostic significance

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objectives

We aimed to define the impact of patient, tumor, surgical, and radiotherapy (RT) treatment parameters on Merkel cell carcinoma (MCC) recurrence and survival.

Methods

The study was a retrospective review of 45 patients with primary disease evaluated between 1981 and 2012 at a single U.S. institution and treated with curative intent.

Results

The American Joint Committee on Cancer (AJCC) stage was I in 42.2 %, II in 8.9 %, III in 26.7 %, and unknown in 22.2 %. 95.6 % underwent primary lesion excision and 69.8 % received adjuvant RT to the tumor bed. Regional management included sentinel lymph node biopsy (35.6 %) and lymph node dissection (28.9 %) with adjuvant RT in 11.1 % and 13.3 %, respectively. 24 patients recurred, mostly at locoregional (LR) (50.0 %) and distant (41.7 %) sites. Only one in-field recurrence occurred after primary site RT. In univariate analysis, RT was associated with reduced (p = 0.003) and head and neck tumors with increased (p = 0.01) risk of LR recurrence. Higher AJCC and nodal stage patients were more likely to receive nodal dissection (p < 0.01) and had a decreased risk of LR recurrence (p < 0.05), but had a median survival time that was nearly half that of lower stage patients. No tested RT parameter was associated with outcomes.

Conclusions

Our study supports the efficacy of RT in improving LR control in MCC compared to excision alone and emphasizes the importance of surgical nodal evaluation.

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Acknowledgments

We would like to thank the Stanford School of Medicine Medical Scholars Research Program for the support of this project.

Author information

Author notes

  1. Evan C. Osmundson

    Present address: Department of Radiation Oncology, Vanderbilt School of Medicine, B1003 Preston Research Building, Nashville, TN, 37212, USA

Authors and Affiliations

  1. Stanford School of Medicine, 291 Campus Drive, Stanford, CA, 94305, USA

    Michael A. Fu

  2. Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA

    Evan C. Osmundson, Rie von Eyben, Susan J. Knox & Daniel S. Kapp

Authors
  1. Michael A. Fu
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  2. Evan C. Osmundson
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Corresponding author

Correspondence to Michael A. Fu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Statement of ethical standards

Institutional Review Board approval was obtained and HIPAA compliance was followed for a retrospective review of hospital, radiation therapy, and surgical pathology records. This article does not contain any studies with human or animal subjects performed by any of the authors.

Funding source(s)

This study was funded in part by the Stanford School of Medicine Medical Scholars Research Program.

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Fu, M.A., Osmundson, E.C., von Eyben, R. et al. Merkel cell carcinoma: demographic, clinical, and treatment parameters of prognostic significance. J Radiat Oncol 5, 205–212 (2016). https://doi.org/10.1007/s13566-016-0255-6

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  • DOI: https://doi.org/10.1007/s13566-016-0255-6

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